Provider Demographics
NPI:1326597667
Name:BARESS, MARIBETH (OTR)
Entity Type:Individual
Prefix:
First Name:MARIBETH
Middle Name:
Last Name:BARESS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:MARIBETH
Other - Middle Name:
Other - Last Name:CASTALDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-258-2714
Mailing Address - Fax:
Practice Address - Street 1:655 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH ABINGTON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18411-8740
Practice Address - Country:US
Practice Address - Phone:570-587-2142
Practice Address - Fax:570-587-1978
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC014477225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOC014477OtherPA STATE LICENSE